弥散张量成像在继发全面性发作癫痫患者中的应用研究

Diffusion tensor imaging in patients with secondary generalized epilepsy

摘要:

目的 评价弥散张量成像（DTI）对于常规MRI未发现病灶的部分性继发全面性发作癫痫患者的病灶检出能力。方法 使用Siemens 3.0T磁共振成像系统对30例成年继发全面性发作癫痫患者和30例正常对照者进行扫描，得到弥散加权成像，采用基于体素的分析方法对癫痫患者和正常对照组的数据进行分析。结果 癫痫组右侧梭状回和楔前叶、右侧额内侧回和钩回、左侧扣带回、左侧颞下回、左侧小脑扁桃体和左侧中央前回的脑区FA值较正常对照组降低，差异有统计学意义（P<0.001）；癫痫组右侧海马旁回、右侧颞下回、右侧胼胝体、右侧额内侧回、右侧额下回、扣带回、右侧前扣带回、右侧舌回、右侧梭状回和枕中回，左侧颞中回、左侧钩回和左侧中央前回的脑区ADC值较正常对照组升高，差异具有统计学意义（P<0.001）；左侧直回的脑区ADC值较正常对照组降低，差异具有统计学意义（P<0.001）。结论 DTI检查可发现常规MRI检查为阴性的部分性继发全面性发作癫痫患者存在的广泛脑白质微结构异常。

Abstract:

Objective To assess the role of diffusion tensor imaging (DTI) in detecting seizure foci which can not be seen in conventional MRI in patients with secondary generalized epilepsy.Methods The diffusion weighted imaging results were obtained in 30 adult patients with secondary generalized seizures and 30 healthy controls using Siemens 3.0T MRI system.The data from patients and controls were analyzed on basis of voxel-based analysis.Results Fractional anisotropy (FA) of the patients decreased significantly compared with the controls (P<0.001) in the right uniform gyrus and precuneus, right medial frontal gyrus and uncus, left cingulate gyrus, inferior temporal gyrus, cerebellar tonsils, and left precentral gyrus.Apparent diffusion coefficient (ADC) of the patients was significantly higher than the controls in the right parahippocampal gyrus, inferior temporal gyrus, corpus callosum, the right medial frontal gyrus, inferior frontal gyrus, cingulate gyrus, anterior cingulate gyrus, lingual gyrus, fusiform gyrus and occipital gyrus, left middle temporal gyrus, uncus and left precentral gyrus (P<0.001).However, ADC in the left gyrus rectus of the patients decreased significantly compared with the controls.Conclusions Extensive white matter microstructure abnormalities which cannot be seen on conventional MRI can be in patients with secondary generalized seizures by DTZ.